Psychometric Properties of the Defense Mechanisms Rating Scales-Self-Report-30 (DMRS-SR-30): Internal Consistency, Validity and Factor Structure

References

• American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders. 4th ed. American Psychiatric Press.
   Google Scholar
• Andrews, G., Singh, M., & Bond, M. (1993). The defense style questionnaire. The Journal of Nervous and Mental Disease, 181(4), 246–256. https://doi.org/10.1097/00005053-199304000-00006
   PubMed Web of Science ®Google Scholar
• Békés, V., Prout, T. A., Di Giuseppe, M., Wildes Ammar, L., Kui, T., Arsena, G., & Conversano, C. (2021). Initial validation of the defense mechanisms rating scales Q-sort: A comparison of trained and untrained raters. Mediterranean Journal of Clinical Psychology, 9(2), 1–19. https://doi.org/10.13129/2282-1619/mjcp-3107
   Web of Science ®Google Scholar
• Bond, M., & Perry, J. C. (2004). Long-term changes in defense styles with psychodynamic psychotherapy for depressive, anxiety, and personality disorders. The American Journal of Psychiatry, 161(9), 1665–1671. https://doi.org/10.1176/appi.ajp.161.9.1665
   PubMed Web of Science ®Google Scholar
• Chabrol, H., Rousseau, A., Rodgers, R., Callahan, S., Pirlot, G., & Sztulman, H. (2005). A study of the face validity of the 40 item version of the Defense Style Questionnaire (DSQ-40). The Journal of Nervous and Mental Disease, 193(11), 756–758. https://doi.org/10.1097/01.nmd.0000185869.07322.ed
   PubMed Web of Science ®Google Scholar
• Chen, R., Rafaeli, E., Ziv-Beiman, S., Bar-Kalifa, E., Solomonov, N., Barber, J. P., Peri, T., & Atzil-Slonim, D. (2020). Therapeutic technique diversity is linked to quality of working alliance and client functioning following alliance ruptures. Journal of Consulting and Clinical Psychology, 88(9), 844–858. https://doi.org/10.1037/ccp0000490
   PubMed Web of Science ®Google Scholar
• Conversano, C. (2021). The psychodynamic approach during COVID-19 emotional crisis. Frontiers in Psychology, 12, 670196. https://doi.org/10.3389/fpsyg.2021.670196
   PubMed Web of Science ®Google Scholar
• Conversano, C., & Di Giuseppe, M. (2021). Psychological factors as determinants of chronic conditions: clinical and psychodynamic advances. Frontiers in Psychology, 12, 635708. https://doi.org/10.3389/fpsyg.2021.635708
   PubMed Web of Science ®Google Scholar
• Conversano, C., Di Giuseppe, M., Miccoli, M., Ciacchini, R., Gemignani, A., & Orrù, G. (2020). Mindfulness, age and gender as protective factors against psychological distress during COVID-19 pandemic. Frontiers in Psychology, 11, 1900. https://doi.org/10.3389/fpsyg.2020.01900
   PubMed Web of Science ®Google Scholar
• Cramer, P., & Davidson, K. (Eds.). (1998). Defense mechanisms in contemporary personality research [Special issue]. Journal of Personality, 66(6), 879–1157.
   Web of Science ®Google Scholar
• Cramer, P. (1991). The defense mechanism manual. In P. Cramer (Ed.), The development of defense mechanisms (pp. 215–234). pringer.
   Google Scholar
• Cramer, P. (1998). Coping and defense mechanisms: what’s the difference? Journal of Personality, 66(6), 919–946. https://doi.org/10.1111/1467-6494.00037
   Web of Science ®Google Scholar
• Cramer, P. (2008). Seven pillars of defense mechanisms theory. Social and Personality Psychology Compass, 2(5), 1963–1981. https://doi.org/10.1111/j.1751-9004.2008.00135.x
   Google Scholar
• Davidson, K., & MacGregor, M. W. (1998). A critical appraisal of self-report defense mechanism measures. Journal of Personality, 66(6), 965–992. https://doi.org/10.1111/1467-6494.00039
   Web of Science ®Google Scholar
• DeFife, J. A., & Hilsenroth, M. J. (2005). Clinical utility of the Defensive Functioning Scale in the assessment of depression. The Journal of Nervous and Mental Disease, 193(3), 176–182. https://doi.org/10.1097/01.nmd.0000154839.43440.35
   PubMed Web of Science ®Google Scholar
• Delgadillo, J., Rubel, J., & Barkham, M. (2020). Toward personalized allocation of patients to therapists. Journal of Consulting and Clinical Psychology, 88(9), 799–808. https://doi.org/10.1037/ccp0000507
   PubMed Web of Science ®Google Scholar
• Di Giuseppe, M., Ciacchini, R., Micheloni, T., Bertolucci, I., Marchi, L., & Conversano, C. (2018). Defense mechanisms in cancer patients: a systematic review. Journal of Psychosomatic Research, 115, 76–86. https://doi.org/10.1016/j.jpsychores.2018.10.016
   PubMed Web of Science ®Google Scholar
• Di Giuseppe, M., Nepa, G., Prout, T. A., Albertini, F., Marcelli, S., Orrù, G., & Conversano, C. (2021). Stress, burnout, and resilience among healthcare workers during the COVID-19 emergency: the role of defense mechanisms. International Journal of Environmental Research and Public Health, 18(10), 5258. https://doi.org/10.3390/ijerph18105258
   PubMed Web of Science ®Google Scholar
• Di Giuseppe, M., & Perry, J. C. (2021). The hierarchy of defense mechanisms: assessing defensive functioning with the Defense Mechanisms Rating Scales Q-sort (DMRS-Q). Frontiers in Psychology, 12, 718440. https://doi.org/10.3389/fpsyg.2021.718440
   PubMed Web of Science ®Google Scholar
• Di Giuseppe, M., Perry, J. C., Conversano, C., Gelo, O. C. G., & Gennaro, A. (2020). Defense mechanisms, gender, and adaptiveness in emerging personality disorders in adolescent outpatients. The Journal of Nervous and Mental Disease, 208(12), 933–941. https://doi.org/10.1097/NMD.0000000000001230
   PubMed Web of Science ®Google Scholar
• Di Giuseppe, M., Perry, J. C., Lucchesi, M., Michelini, M., Vitiello, S., Piantanida, A., Fabiani, M., Maffei, S., & Conversano, C. (2020). Preliminary validity and reliability of the novel self-report based on the Defense Mechanisms Rating Scales (DMRS-SR-30). Frontiers in Psychiatry, 11, 870. https://doi.org/10.3389/fpsyt.2020.00870
   PubMed Web of Science ®Google Scholar
• Di Giuseppe, M., Perry, J. C., Petraglia, J., Janzen, J., & Lingiardi, V. (2014). Development of a Q-Sort version of the Defense Mechanism Rating Scales (DMRS-Q) for clinical use. Journal of Clinical Psychology, 70(5), 452–465. https://doi.org/10.1002/jclp.22089
   PubMed Web of Science ®Google Scholar
• Dube, S. R., Felitti, V. J., Dong, M., Chapman, D. P., Giles, W., & Anda, R. F. (2003). Childhood abuse neglect and household dysfunction and the risk of illicit drug use: The Adverse Childhood Experiences Study. Pediatrics, 111(3), 564–572. https://doi.org/10.1016/j.chiabu.2003.08.009
   PubMed Web of Science ®Google Scholar
• Dube, S. R., Williamson, D. F., Thompson, T., Felitti, V. J., & Anda, R. F. (2004). Assessing the reliability of retrospective reports of adverse childhood experiences among adult HMO members attending a primary care clinic. Child Abuse & Neglect, 28(7), 729–737. https://doi.org/10.1016/j.chiabu.2003.08.009
   Google Scholar
• Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., Koss, M. P., & Marks, J. S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The Adverse Childhood Experiences (ACE) study. American Journal of Preventive Medicine, 14(4), 245–258. https://doi.org/10.1016/S0749-3797(98)00017-8
   PubMed Web of Science ®Google Scholar
• Flückiger, C., Rubel, J., Del Re, A. C., Horvath, A. O., Wampold, B. E., Crits-Christoph, P., Atzil-Slonim, D., Compare, A., Falkenström, F., Ekeblad, A., Errázuriz, P., Fisher, H., Hoffart, A., Huppert, J. D., Kivity, Y., Kumar, M., Lutz, W., Muran, J. C., Strunk, D. R., … Barber, J. P. (2020). The reciprocal relationship between alliance and early treatment symptoms: A two-stage individual participant data meta-analysis. Journal of Consulting and Clinical Psychology, 88(9), 829–843. https://doi.org/10.1037/ccp0000594
   PubMed Web of Science ®Google Scholar
• Freud, S. (1984). The neuropsychosis of defense (Standard Edition, vol. 3, pp. 41–61). Hogarth Press and the Institute of Psycho-Analysis.
   Google Scholar
• Guldberg, C. A., Høglend, P., & Perry, J. C. (1993). Scientific methods for assessing psychological defenses. Nordic Journal of Psychiatry, 47(6), 435–446. https://doi.org/10.3109/08039489309104112
   Web of Science ®Google Scholar
• Helmich, M. A., Wichers, M., Olthof, M., Strunk, G., Aas, B., Aichhorn, W., Schiepek, G., & Snippe, E. (2020). Sudden gains in day-to-day change: Revealing nonlinear patterns of individual improvement in depression. Journal of Consulting and Clinical Psychology, 88(2), 119–127. https://doi.org/10.1037/ccp0000469
   PubMed Web of Science ®Google Scholar
• Hopwood, C. J., & Bornstein, R. F. (Eds.). (2014). Multimethod clinical assessment. The Guilford Press.
   Google Scholar
• Horowitz, M., Wilner, N., & Alvarez, W. (1979). Impact of Event Scale: A measure of subjective stress. Psychosomatic Medicine, 41(3), 209–218. https://doi.org/10.1097/00006842-197905000-00004
   PubMed Web of Science ®Google Scholar
• Kernberg, O. (1967). Borderline personality organization. Journal of the American Psychoanalytic Association, 15(3), 641–685. https://doi.org/10.1177/000306516701500309
   PubMed Web of Science ®Google Scholar
• Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2001). The PHQ-9: Validity of a brief depression severity measure. Journal of General Internal Medicine, 16(9), 606–613. https://doi.org/10.1046/j.1525-1497.2001.016009606.x
   PubMed Web of Science ®Google Scholar
• Kroenke, K., Spitzer, R. L., Williams, J. B. W., & Löwe, B. (2010). The patient health questionnaire somatic, anxiety, and depressive symptom scales: A systematic review. General Hospital Psychiatry, 32(4), 345–359. https://doi.org/10.1016/j.genhosppsych.2010.03.006
   PubMed Web of Science ®Google Scholar
• MacGregor, M. W., & Olson, T. R. (2005). Defense mechanisms: Their relation to personality and health. An exploration of defense mechanisms assessed by the Defense-Q. In A. Columbus (Ed.), Advances in psychology research (Vol. 36, pp. 95–141). Nova Science Publishers.
   Google Scholar
• McDonald, A., Thompson, A. J., Perzow, S. E. D., Joos, C., & Wadsworth, M. E. (2020). The protective roles of ethnic identity, social support, and coping on depression in low-income parents: A test of the adaptation to poverty-related stress model. Journal of Consulting and Clinical Psychology, 88(6), 504–515. https://doi.org/10.1037/ccp0000477
   PubMed Web of Science ®Google Scholar
• Perry, J. C. (1990). Defense mechanism rating scales (DMRS) (5th ed.). Author.
   Google Scholar
• Perry, J. C. (2014). Anomalies and specific functions in the clinical identification of defense mechanisms. Journal of Clinical Psychology, 70(5), 406–418. https://doi.org/10.1002/jclp.22085
   PubMed Web of Science ®Google Scholar
• Perry, J. C., Banon, E., & Bond, M. (2020). Change in defense mechanisms and depression in a pilot study of antidepressive medications plus 20 sessions of psychotherapy for recurrent major depression. The Journal of Nervous and Mental Disease, 208(4), 261–268. https://doi.org/10.1097/NMD.0000000000001112
   PubMed Web of Science ®Google Scholar
• Perry, J. C., Beck, S. M., Constantinides, P., & Foley, J. E. (2009). Studying change in defensive functioning in psychotherapy, using the Defense Mechanism Rating Scales: four hypotheses, four cases. In R. A. Levy, & J. S. Ablon (Eds.), Handbook of evidenced based psychodynamic psychotherapy (pp. 121–153). Humana Press.
   Google Scholar
• Perry, J. C., & Cooper, S. H. (1989). An empirical study of defense mechanisms: I. Clinical interview and life vignette ratings. Archives of General Psychiatry, 46(5), 444–452.
   PubMed Web of Science ®Google Scholar
• Perry, J. C., & Henry, M. (2004). Studying defense mechanisms in psychotherapy using the Defense Mechanism Rating Scales. In U. Hentschel, G. Smith, J. G. Draguns, & W. Ehlers (Eds.), Defense mechanisms: Theoretical, research and clinical perspectives (pp. 165–192). Elsevier.
   Google Scholar
• Perry, J. C., & Høglend, P. (1998). Convergent and discriminant validity of overall defensive functioning. The Journal of Nervous and Mental Disease, 186(9), 529–535. https://doi.org/10.1097/00005053-199809000-00003
   PubMed Web of Science ®Google Scholar
• Perry, J. C., Hoglend, P., Shear, K., Vaillant, G. E., Horowitz, M., Kardos, M. E., Bille, H., & Kagan, D. (1998). Field trial of a diagnostic axis for defense mechanisms for DSM-IV. Journal of Personality Disorders, 12(1), 56–68. https://doi.org/10.1521/pedi.1998.12.1.56
   PubMed Web of Science ®Google Scholar
• Perry, J. C., Knoll, M., & Tran, V. (2019). Motives, defenses, and conflicts in the dynamic formulation for psychodynamic psychotherapy using the Idiographic Conflict Formulation method. In U. Kramer (Ed.), Case formulation for personality disorders (pp 203–224). Elsevier.
   Google Scholar
• Perry, J. C., & Lanni, F. F. (1998). Observer-rated measures of defense mechanisms. Journal of Personality, 66(6), 993–1024. https://doi.org/10.1111/1467-6494.00040
   Web of Science ®Google Scholar
• Perry, J. C., Metzger, J., & Sigal, J. J. (2015). Defensive functioning among women with breast cancer and matched community controls. Psychiatry, 78(2), 156–169. https://doi.org/10.1080/00332747.2015.1051445
   PubMed Web of Science ®Google Scholar
• Perry, J. C., Presniak, M. D., & Olson, T. R. (2013). Defense mechanisms in schizotypal, borderline, antisocial, and narcissistic personality disorders. Psychiatry, 76(1), 32–52. https://doi.org/10.1521/psyc.2013.76.1.32
   PubMed Web of Science ®Google Scholar
• Prout, T. A., Gottdiener, W. H., Camargo, A., & Murphy, S. (2018). The relationship between defense mechanisms and religious coping using a new two-factor solution for the Defense Style Questionnaire-40. Bulletin of the Menninger Clinic, 82(3), 224–252. https://doi.org/10.1521/bumc.2018.82.3.224
   PubMed Web of Science ®Google Scholar
• Prout, T. A., Zilcha-Mano, S., Aafjes-van Doorn, K., Békés, V., Christman-Cohen, I., Whistler, K., Kui, T., & Di Giuseppe, M. (2020). Identifying predictors of psychological distress during COVID-19: A machine learning approach. Frontiers in Psychology, 11, 586202. https://doi.org/10.3389/fpsyg.2020.586202
   PubMed Web of Science ®Google Scholar
• Ruggero, C. J., Kotov, R., Hopwood, C. J., First, M., Clark, L. A., Skodol, A. E., Mullins-Sweatt, S. N., Patrick, C. J., Bach, B., Cicero, D. C., Docherty, A., Simms, L. J., Bagby, R. M., Krueger, R. F., Callahan, J. L., Chmielewski, M., Conway, C. C., De Clercq, B., Dornbach-Bender, A., … Zimmermann, J. (2019). Integrating the Hierarchical Taxonomy of Psychopathology (HiTOP) into clinical practice. Journal of Consulting and Clinical Psychology, 87(12), 1069–1084. https://doi.org/10.1037/ccp0000452
   PubMed Web of Science ®Google Scholar
• Saint-Martin, C., Valls, M., Rousseau, A., Callahan, S., & Chabrol, H. (2013). Psychometric evaluation of a shortened version of the 40-item defense style questionnaire. International Journal of Psychology and Psychological Therapy, 13(2), 215–224.
   Google Scholar
• Siefert, C. J., Hilsenroth, M. J., Weinberger, J., Blagys, M. D., & Ackerman, S. J. (2006). The relationship of patient defensive functioning and alliance with therapist technique during short-term psychodynamic psychotherapy. Clinical Psychology & Psychotherapy, 13(1), 20–55. https://doi.org/10.1002/cpp.469
   Web of Science ®Google Scholar
• Skodol, A. E., & Perry, J. C. (1993). Should an axis for defense mechanisms be included in DSM-IV? Comprehensive Psychiatry, 34(2), 108–119. https://doi.org/10.1016/0010-440X(93)90055-9
   PubMed Web of Science ®Google Scholar
• Spinhoven, P., van Gaalen, H. A. E., & Abraham, R. E. (1995). The defense style questionnaire: a psychometric examination. Journal of Personality Disorders, 9(2), 124–133. https://doi.org/10.1521/pedi.1995.9.2.124
   Web of Science ®Google Scholar
• Spitzer, R. L., Kroenke, K., & Williams, J. B. W. (1999). Validation and utility of a self-report version of PRIME-MD: The PHQ Primary Care Study. JAMA, 282(18), 1737–1744. https://doi.org/10.1001/jama.282.18.1737
   PubMed Web of Science ®Google Scholar
• Spitzer, R. L., Kroenke, K., Williams, J. B., & Löwe, B. (2006). A brief measure for assessing generalized anxiety disorder: the GAD-7. Archives of Internal Medicine, 166(10), 1092–1097. https://doi.org/10.1001/archinte.166.10.1092
   Google Scholar
• Tanzilli, A., Di Giuseppe, M., Giovanardi, G., Boldrini, T., Caviglia, G., Conversano, C., & Lingiardi, V. (2021). Mentalization, attachment, and defense mechanisms: a Psychodynamic Diagnostic Manual-2-oriented empirical investigation. Research in Psychotherapy: Psychopathology, Process and Outcome, 24(1), 31–41. https://doi.org/10.4081/ripppo.2021.531
   Google Scholar
• Tapp, J., Cottle, L., Christmas, M., Stratton, R., Gannon, T. A., & Moore, E. (2018). A psychometric evaluation of the Defence Style Questionnaire-40 in a UK forensic patient population. The Journal of Forensic Psychiatry & Psychology, 29(2), 288–307. https://doi.org/10.1080/14789949.2017.1375542
   Web of Science ®Google Scholar
• Trijsburg, R. W., van t' Spijker, A., Van, H. L., Hesselink, A. J., & Duivenvoorden, H. J. (2000). Measuring overall defensive functioning with the Defense Style Questionnaire: A comparison of different scoring methods. The Journal of Nervous and Mental Disease, 188(7), 432–439. https://doi.org/10.1097/00005053-200007000-00007
   PubMed Web of Science ®Google Scholar
• Vaillant, G. E. (1992). Ego mechanisms of defense: A guide for clinicians and researchers. American Psychiatric Press.
   Google Scholar
• Vaillant, G. E. (1971). Theoretical hierarchy of adaptive ego mechanisms: A 30-year follow-up of 30 men selected for psychological health. Archives of General Psychiatry, 24(2), 107–118. https://doi.org/10.1001/archpsyc.1971.01750080011003
   PubMed Web of Science ®Google Scholar
• Vaillant, G. E. (1977). Adaptation to life. Little, Brown.
   Google Scholar
• Webb, C. A., Cohen, Z. D., Beard, C., Forgeard, M., Peckham, A. D., & Björgvinsson, T. (2020). Personalized prognostic prediction of treatment outcome for depressed patients in a naturalistic psychiatric hospital setting: A comparison of machine learning approaches. Journal of Consulting and Clinical Psychology, 88(1), 25–38. https://doi.org/10.1037/ccp0000451
   PubMed Web of Science ®Google Scholar
• Weiss, D. S., & Marmar, C. R. (2004). The impact of events scale-revised. In J. P. Wilson, T. M. Keane (Eds.), Assessing psychological trauma and PTSD (pp. 399–411). Guilford Press.
   Google Scholar
• Widiger, T. A. (2017). The Oxford handbook of the five-factor model. Oxford University Press.
   Google Scholar
• Widiger, T. A., & Crego, C. (2019). The Five Factor Model of personality structure: an update. World Psychiatry: Official Journal of the World Psychiatric Association (WPA), 18(3), 271–272. https://doi.org/10.1002/wps.20658
   PubMed Web of Science ®Google Scholar